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Free Content Directly observed treatment for tuberculosis in pharmacies compared with self-administered therapy in Spain

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Abstract:

OBJECTIVES: To compare directly observed treatment (DOT) of tuberculosis through pharmacy offices with self-administered treatment (SAT) in patients at risk for non-adherence.

METHODS: Prospective study for DOT (1999–2002) and retrospective study for SAT (1996–1998) in patients at risk for non-adherence (human immunodeficiency virus [HIV] infection, alcoholism, illicit drug use, immigrant or homeless status and/or previous failure to complete). Patients in the DOT programme received medication as out-patients twice a week in pharmacies that supervised adherence and provided socio-sanitary support to patients.

RESULTS: There were 101 and 112 patients in the DOT and SAT groups, respectively. Demographic and clinical characteristics were similar in both groups. Differences were observed in risk factors for non-adherence (more immigrants and fewer intravenous drug users in the DOT vs. the SAT groups; P < 0.05). In the DOT group, 76 patients (75.2%) completed treatment and were cured compared to only 30 patients (26.7%) in the SAT group (P < 0.001). Implementation of DOT increased the cost of treatment by 400€ per patient compared to SAT.

CONCLUSION: In patients at risk for non-adherence, DOT implemented through pharmacy offices was better than SAT; however, completion rates were still low.

Keywords: directly observed treatment; pharmacy office; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain; and Department of Pneumology, University General Hospital Consortium, Valencia, Spain 2: Department of Pneumology, University General Hospital Consortium, Valencia, Spain 3: Research Foundation, University General Hospital Consortium, Valencia, Spain; and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain 4: Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain

Publication date: February 1, 2006

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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